Chronopharmacology : The right timing can be crucial

Abstract

Chronopharmacology takes into account, among other things, the circadian rhythm, arecurring, daily rhythm of biological functions that is significantly influenced by the day-night rhythm. Daily rhythm, diseases, and therapies influence each other: the circadian rhythm, among other factors, could influence the effect of pharmacological and nonpharmacological therapies, especially in urological oncology. This article focuses on the question of the optimal time for therapeutic interventions and considers relevant basics of chronobiological principles depending on possible biomarkers that could be targets of afuture therapeutic approach. With chronomodulated chemotherapy, cancer therapies are not only more tolerable, but also more effective. Effects and side effects of an active substance can change according to the circadian rhythm. Due to the introduction of particularly targeted, oral tumor therapies, adaily application would be organizationally possible, but further clinical studies are necessary for this. The internal clock could play an unexpected role, especially in hormone-dependent prostate cancer: the amount of the circadian factor Cry1 not only seems to increase in the advanced stage, but is also closely associated with apoorer prognosis. Epidemiological studies also show aconnection between hormone-dependent tumors and the disruption of the rhythmic release of melatonin. Melatonin appears to be able to improve therapy as an adjunct to cancer therapy in some urological tumor entities.